Comments on: CAM Practitioners as Primary Care Doctorshttp://theness.com/neurologicablog/index.php/cam-practitioners-as-primary-care-doctors/
Your Daily Fix of Neuroscience, Skepticism, and Critical ThinkingSat, 01 Aug 2015 21:23:50 +0000hourly1http://wordpress.org/?v=3.4.1By: Doctorrickhttp://theness.com/neurologicablog/index.php/cam-practitioners-as-primary-care-doctors/comment-page-2/#comment-52426
DoctorrickSun, 07 Apr 2013 04:08:59 +0000http://theness.com/neurologicablog/?p=5374#comment-52426Not sure if anyone still following the thread, but saw a major point above (to me at least). "Family Doctor" does indeed have a quite specific and meaningful definition. Family Medicine (or Family Practice) is a specific specialty of medicine. It requires a 3 year residency in an accredited program, with a laid out course structure. In addition passage of a board certification exam. While the term is used loosely by lay people, it is quite firmly defined.Not sure if anyone still following the thread, but saw a major point above (to me at least). “Family Doctor” does indeed have a quite specific and meaningful definition. Family Medicine (or Family Practice) is a specific specialty of medicine. It requires a 3 year residency in an accredited program, with a laid out course structure. In addition passage of a board certification exam. While the term is used loosely by lay people, it is quite firmly defined.
]]>By: BillyJoe7http://theness.com/neurologicablog/index.php/cam-practitioners-as-primary-care-doctors/comment-page-2/#comment-51767
BillyJoe7Fri, 15 Mar 2013 11:05:55 +0000http://theness.com/neurologicablog/?p=5374#comment-51767...<b>apart from</b> when those who can do so find loop holes to avoid paying their share of tax.…apart from when those who can do so find loop holes to avoid paying their share of tax.
]]>By: BillyJoe7http://theness.com/neurologicablog/index.php/cam-practitioners-as-primary-care-doctors/comment-page-2/#comment-51766
BillyJoe7Fri, 15 Mar 2013 10:55:57 +0000http://theness.com/neurologicablog/?p=5374#comment-51766sonic,
Check out the meaning of the equivocation fallacy.
The word "anecdote" on this blog refers to the use of personal experience as evidence or proof of something. That's the way you used the word in your first reply to my post as a way to denigrate it (please do not deny the obvious!). But, in fact, I was using my mother's experience, not as proof or evidence of anything, but as an illustration of the effect of universal health care on people without private health insurance in Australia. That's more in line with your second use of the word. The difference is that my mother's experience is clearly generalisable to the population as a whole (she is not special; she is treated like everyone else in a similar situation), whilst an anecdote, as that word is used on this blog, is not generalisable.
Also where did I say that the system in the USA is, or was ever was, "user pays". I was clearly saying that that is what libertarians would like it to be, which is why that were hell bent in opposing the recent reforms. It was further away from their preferred situation of "everyone for themselves".
Finally, I do not view tax as me paying for ten people. I view tax as paying for infrastructure, education, health, social security, defence etc, with everyone paying according to their level of income/ability to pay. This is a fair and equitable system when those who can do so find loop holes to avoid paying their share of tax. It is also the system that is most conducive to internal harmony and peace amongst the population. So I do not accept your spin.sonic,

Check out the meaning of the equivocation fallacy.
The word “anecdote” on this blog refers to the use of personal experience as evidence or proof of something. That’s the way you used the word in your first reply to my post as a way to denigrate it (please do not deny the obvious!). But, in fact, I was using my mother’s experience, not as proof or evidence of anything, but as an illustration of the effect of universal health care on people without private health insurance in Australia. That’s more in line with your second use of the word. The difference is that my mother’s experience is clearly generalisable to the population as a whole (she is not special; she is treated like everyone else in a similar situation), whilst an anecdote, as that word is used on this blog, is not generalisable.

Also where did I say that the system in the USA is, or was ever was, “user pays”. I was clearly saying that that is what libertarians would like it to be, which is why that were hell bent in opposing the recent reforms. It was further away from their preferred situation of “everyone for themselves”.

Finally, I do not view tax as me paying for ten people. I view tax as paying for infrastructure, education, health, social security, defence etc, with everyone paying according to their level of income/ability to pay. This is a fair and equitable system when those who can do so find loop holes to avoid paying their share of tax. It is also the system that is most conducive to internal harmony and peace amongst the population. So I do not accept your spin.

]]>By: sonichttp://theness.com/neurologicablog/index.php/cam-practitioners-as-primary-care-doctors/comment-page-2/#comment-51722
sonicThu, 14 Mar 2013 16:02:17 +0000http://theness.com/neurologicablog/?p=5374#comment-51722BillyJoe7-
I did some research.
Your government borrowed about 44 billion dollars 2011-2012.
That's about $1,945 per person, right?
I'm guessing you are a tax payer- and that many people aren't-- for example children, elderly, students, lower wage workers...
I'll make a wild guess here-- I did the other math, you can check this-- but I think you probably pay tax for between 4 and 10 people--
So if your tax bill was $8000 to $20,000 higher, then you would be actually paying for the services you are currently getting.
Check that for me would you, it really is a pretty wild guess on my part.
If I'm right, I'm thinking you might realize to what extent your government has been giving you a false impression as to what is actually going on.
We do not have a system in the US where the person getting the service pays for it.
That went out in the late 70's-- And with it the expectation that each person would be able to pay all the doctor bills he got over his lifetime.
Imagine that-- it was only about 40 years ago when the normal person in this country without any form of medical insurance was fine-- they could pay every medical bill-- just like most people can afford food, clothing, shelter, haircuts, water, electricity,...
We opted for a system where it is normal that nobody can afford it-- well it seems there are about 1% who can afford it. :-).
How it is here-
When the Senate and Congress and President were all of the same party they couldn't pass a budget.
They blamed the parties that could not possibly have anything to do with the inability to run the government in a legal manner on this utter failure to govern.
Check out the meaning of the word 'anecdote'-- "a usually short narrative of an interesting, amusing, or biographical incident"BillyJoe7-
I did some research.
Your government borrowed about 44 billion dollars 2011-2012.
That’s about $1,945 per person, right?

I’m guessing you are a tax payer- and that many people aren’t– for example children, elderly, students, lower wage workers…

I’ll make a wild guess here– I did the other math, you can check this– but I think you probably pay tax for between 4 and 10 people–
So if your tax bill was $8000 to $20,000 higher, then you would be actually paying for the services you are currently getting.

Check that for me would you, it really is a pretty wild guess on my part.
If I’m right, I’m thinking you might realize to what extent your government has been giving you a false impression as to what is actually going on.

We do not have a system in the US where the person getting the service pays for it.
That went out in the late 70′s– And with it the expectation that each person would be able to pay all the doctor bills he got over his lifetime.
Imagine that– it was only about 40 years ago when the normal person in this country without any form of medical insurance was fine– they could pay every medical bill– just like most people can afford food, clothing, shelter, haircuts, water, electricity,…

We opted for a system where it is normal that nobody can afford it– well it seems there are about 1% who can afford it. .

How it is here-
When the Senate and Congress and President were all of the same party they couldn’t pass a budget.
They blamed the parties that could not possibly have anything to do with the inability to run the government in a legal manner on this utter failure to govern.

Check out the meaning of the word ‘anecdote’– “a usually short narrative of an interesting, amusing, or biographical incident”

]]>By: BillyJoe7http://theness.com/neurologicablog/index.php/cam-practitioners-as-primary-care-doctors/comment-page-2/#comment-51682
BillyJoe7Wed, 13 Mar 2013 20:20:01 +0000http://theness.com/neurologicablog/?p=5374#comment-51682My mother's case is not anecdotal, it is representative of what happens with universal health cover in Australia. Or do you think the system treated my mother differently to others? If so, why would she be treated differently? She is just pensioner with no influence. She is, in fact, an example of the general case.
Regarding effectiveness and efficiency of universal cover vs user pays.
First of all, I did compare the two. Before the recent changes, the USA spent twice as much of their GDP on health care without achieving universal coverage; and patients went bankrupt if they didn't have sufficient financial reserves and developed a major illness. This just does not happen in Australia. The only problem in Australia is waiting times for non-urgent surgery, but this is better than not getting the surgery at all.
Regarding libertarianism.
Perhaps I didn't follow it closely enough, but it seemed to me that the big opposition to the recent reforms in the USA was based on libertarian ideology (minimal government; anti-social security; pro user pays). I am willing to concede this point though if my impressions can be shown to be incorrect.My mother’s case is not anecdotal, it is representative of what happens with universal health cover in Australia. Or do you think the system treated my mother differently to others? If so, why would she be treated differently? She is just pensioner with no influence. She is, in fact, an example of the general case.

Regarding effectiveness and efficiency of universal cover vs user pays.
First of all, I did compare the two. Before the recent changes, the USA spent twice as much of their GDP on health care without achieving universal coverage; and patients went bankrupt if they didn’t have sufficient financial reserves and developed a major illness. This just does not happen in Australia. The only problem in Australia is waiting times for non-urgent surgery, but this is better than not getting the surgery at all.

Regarding libertarianism.
Perhaps I didn’t follow it closely enough, but it seemed to me that the big opposition to the recent reforms in the USA was based on libertarian ideology (minimal government; anti-social security; pro user pays). I am willing to concede this point though if my impressions can be shown to be incorrect.

]]>By: sonichttp://theness.com/neurologicablog/index.php/cam-practitioners-as-primary-care-doctors/comment-page-2/#comment-51671
sonicWed, 13 Mar 2013 15:40:29 +0000http://theness.com/neurologicablog/?p=5374#comment-51671BillyJoe7-
It is nice that your mother is being taken care of so well.
The question was about effective and efficient- your response doesn't mention either-- nor does it compare the system you are touting to one in which each person who receives a service pays for that service.
So I'll file it under 'interesting anecdote'.
BTW--
Where I live there are currently zero (none, nil) libertarians elected to our federal government. (none in the State or local either).
As our system is one based on votes- one can see the libertarians have zero votes when it comes to determining how anything in this country is run. Zero votes.
I am amazed at how many people believe any disfunction that exists in our government could have anything to do with libertarians.
I have noticed that it is not unusual for a group to blame many bad things on the member not present.
I try to avoid that behavior.
I'd never make it as a politician here. :-)BillyJoe7-
It is nice that your mother is being taken care of so well.

The question was about effective and efficient- your response doesn’t mention either– nor does it compare the system you are touting to one in which each person who receives a service pays for that service.
So I’ll file it under ‘interesting anecdote’.

BTW–
Where I live there are currently zero (none, nil) libertarians elected to our federal government. (none in the State or local either).
As our system is one based on votes- one can see the libertarians have zero votes when it comes to determining how anything in this country is run. Zero votes.
I am amazed at how many people believe any disfunction that exists in our government could have anything to do with libertarians.

I have noticed that it is not unusual for a group to blame many bad things on the member not present.
I try to avoid that behavior.
I’d never make it as a politician here.

]]>By: BillyJoe7http://theness.com/neurologicablog/index.php/cam-practitioners-as-primary-care-doctors/comment-page-2/#comment-51626
BillyJoe7Tue, 12 Mar 2013 20:44:17 +0000http://theness.com/neurologicablog/?p=5374#comment-51626sonic,
It is not conjecture.
Come down to Australia if you want your eyes opened.
We have universal health cover paid for out of taxes, with those being able to afford private health insurance but choosing not to take out private health insurance having to pay 5% extra in tax.
No one goes bankrupt paying medical bills and the country spends 9% GDP on health for a much better return than the 19% spent in the USA.
In the last few years, my mother has had a total hip replacement and had a colon tumour removed and is on the waiting list for another hip replacement. She is unable to afford private health insurance and she is on a pension, so the cost to her is nil.
What we don't have is an influential group of libertarians telling us this is wrong.sonic,

It is not conjecture.

Come down to Australia if you want your eyes opened.

We have universal health cover paid for out of taxes, with those being able to afford private health insurance but choosing not to take out private health insurance having to pay 5% extra in tax.
No one goes bankrupt paying medical bills and the country spends 9% GDP on health for a much better return than the 19% spent in the USA.
In the last few years, my mother has had a total hip replacement and had a colon tumour removed and is on the waiting list for another hip replacement. She is unable to afford private health insurance and she is on a pension, so the cost to her is nil.

What we don’t have is an influential group of libertarians telling us this is wrong.

]]>By: sonichttp://theness.com/neurologicablog/index.php/cam-practitioners-as-primary-care-doctors/comment-page-2/#comment-51622
sonicTue, 12 Mar 2013 19:31:18 +0000http://theness.com/neurologicablog/?p=5374#comment-51622Bill-
Before we get too far into this please understand-
I have been the guy with no money, and no insurance before-- (no address either...)
This doesn't make me an expert in anything- but please don't think I don't know or care about people in that situation. OK?
I agree that insurance doesn't lower cost. It is most efficient and effective to have the person getting a service to pay for it directly.
I believe that is a fact.
You then say that 'universal insurance coverage' is the most effective and efficient method of delivering a service.
I believe that is conjecture.
It appears the conjecture is in direct conflict with the fact.
I believe that needs to be addressed before sensible communication can occur.Bill-
Before we get too far into this please understand-
I have been the guy with no money, and no insurance before– (no address either…)
This doesn’t make me an expert in anything- but please don’t think I don’t know or care about people in that situation. OK?

I agree that insurance doesn’t lower cost. It is most efficient and effective to have the person getting a service to pay for it directly.
I believe that is a fact.
You then say that ‘universal insurance coverage’ is the most effective and efficient method of delivering a service.
I believe that is conjecture.

It appears the conjecture is in direct conflict with the fact.
I believe that needs to be addressed before sensible communication can occur.

]]>By: Bill Openthalthttp://theness.com/neurologicablog/index.php/cam-practitioners-as-primary-care-doctors/comment-page-2/#comment-51601
Bill OpenthaltTue, 12 Mar 2013 12:28:58 +0000http://theness.com/neurologicablog/?p=5374#comment-51601Sonic --
<blockquote>So I knew how to cut my medical bills by 35%– just don’t have insurance and pay cash. This is something that I could work with.
But that’s not going to be an option much longer, I don’t think.
It seems the public bought the notion that having insurance would lower the cost. I don’t know how having more people handle your money lowers the cost, but it sells for the politicians. (I have insurance now– don’t worry). </blockquote>
Insurance doesn't lower the cost, it spreads the cost and the risk over a large number of people. As long as you have enough cash to pay for the procedures you need, you are better off self-insured, but if the procedure is too expensive for your pocket-book, you are out of luck.
Our society believes people who need medical care should get medical care. The most efficient and effective way to deliver medical care based on need, is through universal medical insurance. The care providers will be paid, the patients and their families will not be ruined, and with good actuarial management, the cost to each of us will be the lowest. Of course, there are ideology-related decisions to be made -- should the treatment be free, or should costs be refunded, should the premium be linked to the income, should all treatments (no matter how expensive) be covered, should life be extended at all cost, etc.
The simple fact remains that many European countries provide on average better health care for more people at a lower cost (in terms of GDP) than the USA. The flip side is that for cutting-edge care, the USA still rules, and that healthy people spend a lot less on health-care in the USA than in Europe.Sonic –

So I knew how to cut my medical bills by 35%– just don’t have insurance and pay cash. This is something that I could work with.
But that’s not going to be an option much longer, I don’t think.
It seems the public bought the notion that having insurance would lower the cost. I don’t know how having more people handle your money lowers the cost, but it sells for the politicians. (I have insurance now– don’t worry).

Insurance doesn’t lower the cost, it spreads the cost and the risk over a large number of people. As long as you have enough cash to pay for the procedures you need, you are better off self-insured, but if the procedure is too expensive for your pocket-book, you are out of luck.

Our society believes people who need medical care should get medical care. The most efficient and effective way to deliver medical care based on need, is through universal medical insurance. The care providers will be paid, the patients and their families will not be ruined, and with good actuarial management, the cost to each of us will be the lowest. Of course, there are ideology-related decisions to be made — should the treatment be free, or should costs be refunded, should the premium be linked to the income, should all treatments (no matter how expensive) be covered, should life be extended at all cost, etc.

The simple fact remains that many European countries provide on average better health care for more people at a lower cost (in terms of GDP) than the USA. The flip side is that for cutting-edge care, the USA still rules, and that healthy people spend a lot less on health-care in the USA than in Europe.

]]>By: BillyJoe7http://theness.com/neurologicablog/index.php/cam-practitioners-as-primary-care-doctors/comment-page-2/#comment-51592
BillyJoe7Tue, 12 Mar 2013 03:55:49 +0000http://theness.com/neurologicablog/?p=5374#comment-51592S: "There is no job for a spade that can’t be accomplished with a shovel and some elbow grease"
Try digging post holes with a shovel. ;)S: “There is no job for a spade that can’t be accomplished with a shovel and some elbow grease”